Background: The purpose of this study was to evaluate outcomes of free flap reconstruction for advanced osteoradionecrosis (ORN) defects and develop an algorithm to guide surgical planning.
Methods: All cases involving free flap reconstruction for ORN of the mandible between 1998 and 2008 were reviewed. A defect classification scheme was developed. Flap selection and outcomes were analyzed and evaluated by defect type.
Results: Seventy-five free flaps and 13 pedicle flaps were performed in 63 patients. Total flap loss was 5%. Overall surgical complication was 32%. Complication rates were higher with bone flaps than with soft tissue flaps (p = .018). A full oral diet was tolerated in 57% of patients, whereas 26% required partial tube feeding, and 16% were tube-feeding dependent.
Conclusion: Free flap reconstruction of advanced ORN defects can be safely performed in a variety of flap configurations with good outcomes. The classification scheme may assist in flap selection.
Copyright © 2010 Wiley Periodicals, Inc.